ABSTRACT
ABSTRACT Chronic lymphocytic leukemia is characterized by clonal proliferation and progressive accumulation of B-cell lymphocytes that typically express CD19+, CD5+ and CD23+. The lymphocytes usually infiltrate the bone marrow, peripheral blood, lymph nodes, and spleen. The diagnosis is established by immunophenotyping circulating B-lymphocytes, and prognosis is defined by two staging systems (Rai and Binet) established by physical examination and blood counts, as well as by several biological and genetic markers. In this update, we present the recommendations from the Brazilian Group of Chronic Lymphocytic Leukemia for the diagnosis and treatment of chronic lymphocytic leukemia. The following recommendations are based on an extensive literature review with the aim of contributing to more uniform patient care in Brazil and possibly in other countries with a similar social-economic profile.
Subject(s)
Prognosis , Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis , Leukemia, Lymphocytic, Chronic, B-Cell/therapy , Immunophenotyping , Cytogenetics , Neoplasm StagingABSTRACT
Relata-se um raro caso de linfoma primário de tiroide em uma mulher de 52 anos com hipotiroidismo associado à tiroidite crônica de Hashimoto. Houve rápido crescimento de um tumor cervical antero-medial, com sintomas de compressão nas vias aéreas superiores e no esôfago. Imagens de tomografia computadorizada com contraste e de endoscopia digestiva alta confirmaram os efeitos compressivos. O linfoma de células B CD20+ primário de tiróide foi diagnosticado por punção aspirativa com agulha grossa e exame histológico e imunoistoquímico. Imagens incidentais do pescoço e da cabeça revelaram um aneurisma cerebral. Com base no diagnóstico, a paciente se submeteu com sucesso a quimioterapia e radioterapia e houve controle do linfoma. A paciente continua em acompanhamento nos ambulatórios de Oncologia e de Neurocirugia. Olinfoma primário de tiroide pode apresentar-se como uma massa indolor na região cervical anterior e média, causando dificuldades de diagnóstico. A relação, causal ou casual, entre linfomas e aneurismas cerebrais nãoestá bem definida.
A rare case of primary lymphoma of the thyroid is reported in a 52-year-old woman with a previous history of hypothyroidism due to Hashimoto?sthyroiditis, and rapid development of an anteromedial cervical tumor with symptoms of extrinsic compression over the upper airways and the esophagus. Contrasted computed tomography images and upper digestive endoscopy confirmed the compressive mass effects. The primary B-cellCD20+ lymphoma of the thyroid was diagnosed by thick-needle biopsy with histological and immunohistochemical evaluation. Incidental images of the head and neck revealed a cerebral aneurysm. Based on the diagnosis, the patient successfully underwent chemotherapy and radiation therapy with control of the lymphoma and is under surveillance in the Oncology andNeurosurgery outpatient care center. Primary lymphoma of the thyroid can present as a painless anterior and medial mass on the neck, leading to diagnosis challenges. The casual or causal relationship between lymphomas and cerebral aneurysms remains unclear.